Well-managed policies and approaches for the pricing and procurement of health technologies are vital for low- and middle-income countries (LMICs) to ensure the availability and affordability of essential medicines and health products for their populations.

With the inclusion of a specific target on universal health coverage (UHC) in the Sustainable Development Goals, countries are increasingly working to build health systems that provide access to high-quality essential health care services; safe, effective, and affordable essential medicines and vaccines for all; as well as financial risk protection (SDG target 3.8).

However, high prices of some medicines and other health technologies are causing significant challenges for policy-makers in LMICs to reach these health goals.

“For countries looking to implement universal health coverage, financial sustainability is key. Appropriate policies for pricing and procurement are essential to improve the affordability of health technologies and ensure their availability for those who need them,” said Cecilia Oh, Programme Advisor for the Access and Delivery Partnership, United Nations Development Programme (UNDP).

The Access and Delivery Partnership (ADP) is committed to strengthening capacities in LMICs and supporting them as they seek to establish sustainable universal health coverage.

ADP recently organized two training workshops for government stakeholders on strengthening national policy frameworks to improve pricing and procurement of medicines and health technologies for UHC.

In Dubai on 19-21 March 2019, participants met to discuss the policy considerations surrounding public health procurement. Country delegates shared their experiences, including key successes that have been achieved and challenges overcome. Through facilitated dialogue around key themes, the participants identified opportunities for revising existing policies and developing new policies to govern the unique facets of health commodity procurement. The workshop concluded with tangible country action plans for potential future ADP work to support procurement policy reform.

The workshop in Bangkok on 26-29 March 2019 was aimed at enabling participants to understand available options in pricing of health commodities and their potential implications in the context of achieving universal health coverage. Country stakeholders learned about current successful policy strategies being implemented in other countries and engaged in exercises to apply these strategies to their own contexts, including stakeholder analyses, evidence-based decision-making, and combinations of strategic pricing methods. During the workshops, participants identified their individual policy priorities, boiled them down to tangible goals, and developed country-level actionable plans that will be refined and implemented in the coming months.

“In Ghana, relatively high prices of medicines are a key challenge. Medicines prices are considered high, compared with international reference prices or other similar markets,” said Brian Adu Asare, Pharmacist and Technical Advisor at the National Drugs Programme in Ghana. “This has an impact on our national health insurance scheme. Lower prices would help us to cover more services and to run the services for a longer period of time, increasing sustainability. We want to be able to bring the prices down optimally and sustainably. This is the motivation driving the current reforms in medicines pricing in Ghana.”

In addition, participants gained insight into the rapidly changing procurement landscape, and were equipped with tools and policy options specific to health commodities that have the potential to improve their supply chain management.

“Procurement decision-makers from different agencies within each country were able to better understand each other’s perspective, and dialogue on how to implement policy to best support the overall needs of the country,” said Betsy Wilskie, Procurement Officer at PATH.

“Country procurement legal frameworks should be reformed to meet the emerging trends and opportunities of the world economic order to bring about the changes that will drive public procurement to achieve the desired savings and efficiency for economic growth and development,” said AB Adjei, Chief Executive, Public Procurement Authority, Ghana.

These trainings brought together participants from 12 countries: Bhutan, Ghana, India, Indonesia, Kenya, Malawi, Papua New Guinea, Philippines, Senegal, Tanzania, Thailand and Uganda. A total of 78 participants across a range of responsibilities and sectors attended, including from public procurement agencies, drug regulatory authorities, national health insurance schemes and ministries of health. Given the complexity of the pricing and procurement issues, the workshops provided useful opportunities for the multiple stakeholders to share experiences and strengthen linkages within and between countries. 

Moving forward, the technical competencies gained from these workshops will stimulate further discussions in the participants’ home countries on identifying key challenges and solutions to improve policies and approaches for pricing and procurement. ADP will continue to support country stakeholders in providing capacity building and policy advisory support at the country level, as part of the overarching aim to improve affordability and availability of essential medicines and health products and accelerate progress towards UHC.  

The Access and Delivery Partnership is supported by the Government of Japan, and implemented by four core partners: UNDP, the World Health Organization, the Special Programme for Tropical Disease Research (TDR) and PATH.